Fiehler J, Thomalla G
Klinik und Poliklinik für Neuroradiologische Diagnostik und Intervention, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland.
Klinik und Poliklinik für Neurologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland.
Nervenarzt. 2015 Oct;86(10):1200-8. doi: 10.1007/s00115-015-4267-z.
The indications for mechanical thrombectomy are based on a proximal vessel occlusion in the absence of extensive ischemic damage in the corresponding dependent vascular territory. The maximum extent of early ischemic edema for which endovascular treatment is still useful is not clear from the studies. A benefit of mechanical thrombectomy can be safely assumed with an ASPECT score of 6-10, possibly also with lower scores. A more complex imaging with assessment of the status of collateral vessels or perfusion abnormality is scientifically interesting but usually not necessary for clinical decision-making for endovascular stroke treatment within the first 6 h after symptom onset.
机械取栓的适应症基于近端血管闭塞且相应供血血管区域无广泛缺血损伤。目前的研究尚不清楚血管内治疗仍有效的早期缺血性水肿的最大范围。ASPECT评分为6 - 10分时，可以安全地认为机械取栓有益，评分更低时可能也有益。对侧支血管状态或灌注异常进行更复杂的成像在科学上很有意义，但对于症状发作后6小时内进行血管内卒中治疗的临床决策通常并非必要。
